Brucellosis in children: A disease with multiple features

Abstract

Brucellosis is a common infection of children in Iran. Considering the prevalence of complications in children, early diagnosis and treatment are crucial for prevention of morbidity and mortality. We retrospectively (1996–2005) studied all children who were diagnosed with brucellosis in one of the largest referral pediatric hospitals in Tehran, Iran. Inclusion criteria were positive Wright test (≥ 1/80 in Iranian population) and 2-mercaptoethanol (≥ 1/20) or isolation of brucella in sterile body fluids. Clinical manifestations, serologic, radiologic and other laboratory findings were analyzed. Data were evaluated on medical reports of 54 children with brucellosis during 1996–2005. The clinical manifestations varied: fever in 40 patients (72%), arthralgia in 27 (50%), hepatosplenomegaly in 18 (32%) and gastrointestinal involvement in 17 (31%). One third of patients had anemia and 25 of them (46%) had low mean corpuscular volume values. Erythrocyte sedimentation rate was more than 20 in 34 (75%) of examined patients. Wright was performed in all patients, 26 (48%) of whom had titers equal or more than 1/320. Coombs Wright was 1/320 in 18 (33%), and 2-mercaptoethanol was positive in all patients (≥ 1/20). Common antibiotic regimens were co-trimoxazole plus rifampin, co-trimoxazole plus streptomycin and co-trimoxazole plus rifampin and gentamicin. Brucellosis presents with variable manifestations, so diagnosis may be difficult, resulting in delay of treatment. Therefore, early diagnosis and treatment by more effective combinations will be useful for decreasing the rate of morbidity, mortality and relapse.

Keywords

Brucellosis - children